Polio Vaccine Research Articles

Adherence of inactivated polio vaccine immunization for children in Central Java Province

Indonesia is a country with high-risk polio transmission. Administering inactivated polio vaccination (IPV) after drops-polio or oral polio vaccination (OPV) was a strategy stopping polio transmission because its ability to ward off poliovirus which was very dangerous. The IPV coverage was very low and have never reached the target since it was launched in 2016. The study purpose was analyzing determinants factors of IPV adherence. A cross-sectional survey conducted in 31 districts in Central Java Province. Sample was 685 children aged 11-23 months and selected using purposive and accidental sampling method. Collecting data by interview using structured questionnaire and observation with maternal and child health (MCH) Handbook to identify immunization status. The collected data was analyzed univariate, bivariate, and multivariate. As many as 74.3% of children received IPV. Partially, variables of delivery history, immunization status, knowledge, attitudes, sources of information, and service satisfaction were related to IPV adherence. Simultaneously, immunization status, attitudes, and sources of information influenced IPV adherence with an overall effect 35.2%. Immunization status as the dominant influencing factor. Efforts were needed reducing resistance to IPV through psychological approach that was motivating and personal, also using of social media as a medium for positive information and communication, in addition to improve immunization service system.

Population Movement and Poliovirus Spread across Pakistan and Afghanistan in 2023.

Population movement dynamics are a critical part of understanding communicable disease transmission patterns and determining where, when, and with whom to deliver appropriate prevention interventions. This study aimed to identify the origin of the Afghan population and their patterns of movement within Karachi, to assess the polio vaccination status of children under the age of five, and to investigate the travel history and guest arrival patterns of individuals from Afghanistan and other regions known to be affected by wild poliovirus type 1 (WPV1) within the past six months. A cross-sectional survey was conducted in selected 12 union councils of Karachi, Pakistan. The data were collected through interviews with Afghan household members and from the frontline workers (FLWs) responsible for the polio vaccination of the children of the same households. Cohen's kappa was used to check the agreement between information provided by the household participant and FLWs. A total of 409 Afghan household members were interviewed. Travel of any household member outside the city within the last six months was reported by 105 (25.7%) participants, 140 (34.2%) hosted guests within the last six months, and 92 (22.5%) participants reported that guest children were vaccinated in their households. A total of 230 (56.2%) participants observed polio teams at relatives' households within Karachi, and 127 (31.1%) observed polio teams at relatives' households outside Karachi in different districts of Pakistan and Afghanistan. Fair to moderate agreement was observed between information provided by the household members and FLWs on the variable's duration of living at current residence (Kappa = 0.370), travel history (Kappa = 0.429), guest arrival (Kappa = 0.395), and household children vaccinated for OPV (Kappa = 0.419). Substantial population mobility was observed between Afghanistan and Pakistan as well as significant movement of the Afghan population within Karachi in the last six months. These findings warrant attention and targeted implementation of interventions to enhance and sustain both routine and supplementary immunization activities within this demographic group.

Non-uptake of dual protective polio vaccine and its determinants among children in Ethiopia using Ethiopian Demographic Health Survey 2019: a mixed-effect model

IntroductionThe polio vaccine is the live-attenuated antigen that prevents poliomyelitis. According to a report by the WHO, about 1 million less than 5-year-old children missed the polio vaccination from 2018...

Contradictory mortality results in early 2-dose measles vaccine trials: interactions with oral polio vaccine may explain differences

ObjectivesBetween 2003 and 2019, three trials (randomised controlled trials [RCTs]) in Guinea-Bissau randomised infants to an early 2-dose measles vaccine (MV) schedule at 4 and 9 months vs standard MV at 9 months. The RCTs produced contradictory mortality results; the effect being beneficial in the 2-dose group in the first but tending to have higher mortality in the last two RCTs. We hypothesised that increased frequency of campaigns with oral polio vaccine (C-OPV) explained the pattern. MethodsWe performed per-protocol analysis of individual-level survival data from the three RCTs in Cox proportional hazards models yielding hazard ratios (HR) for the 2-dose vs the 1-dose MV group. We examined whether timing of C-OPVs and early administration of OPV0 (birth to day 14) affected the HRs for 2-dose/1-dose MV. ResultsThe combined HR(2-dose/1-dose) was 0.79 (95% confidence interval: 0.62-1.00) for children receiving no C-OPV-before-enrolment, but 1.39 (0.97-1.99) for those receiving C-OPV-before-enrolment (homogeneity, P = 0.01). C-OPV-before-enrolment had a beneficial effect in the 1-dose group but tended to have a negative effect in the 2-dose group, especially in females. These effects were amplified further by early administration of OPV0. ConclusionIn the absence of C-OPVs, an early 2-dose MV strategy had beneficial effects on mortality, but frequent C-OPVs may have benefitted the 1-dose group more than the 2-dose MV group, leading to varying results depending on the intensity of C-OPVs.

Monitoring the VDPV2 outbreak in Egypt during 2020–2021 highlights the crucial role of environmental surveillance and boosting immunization in combating Poliovirus

BackgroundPoliovirus is a highly infectious enterovirus (EV) that primarily affects children and can lead to lifelong paralysis or even death. Vaccine-derived polioviruses (VDPVs) are a great threat since they are derived from the attenuated virus in the Oral Poliovirus Vaccine (OPV) and can mutate to a more virulent form. The purpose of this study was to identify VDPV serotype 2 through the year 2020–2021 via surveillance of sewage samples collected from different localities and governorates in Egypt and stool specimens from Acute Flaccid Paralysis (AFP) cases. Both were collected through the national poliovirus surveillance system and according to the guidelines recommended by the WHO.MethodsA total of 1266 sewage samples and 3241 stool samples from January 2020 to December 2021 were investigated in the lab according to World Health Organization (WHO) protocol for the presence of Polioviruses by cell culture, molecular identification of positive isolates on L20B cell line was carried out using real-time polymerase chain reactions (RT-PCR). Any positive isolates for Poliovirus type 2 and isolates suspected of Vaccine Derived Poliovirus Type 1 and type 3 screened by (VDPV1) or Vaccine Poliovirus Type 3 (VDPV3) assay in RT-PCR were referred for VP1 genetic sequencing.ResultsThe outbreak was caused by circulating VDPV2 (cVDPV2) strains started in January 2021. By the end of February 2021, a total of 11 cVDPV2s were detected in sewage samples from six governorates confirming the outbreak situation. One additional cVDPV2 was detected later in the sewage sample from Qena (June 2021). The first and only re-emergence of VDPV2 in stool samples during the outbreak was in contact with Luxor in June 2021. By November 2021, a total of 80 VDPVs were detected. The Egyptian Ministry of Health and Population (MOHP), in collaboration with the WHO, responded quickly by launching two massive vaccination campaigns targeting children under the age of five. Additionally, surveillance systems were strengthened to detect new cases and prevent further spread of the virus.ConclusionThe continued threat of poliovirus and VDPVs requires ongoing efforts to prevent their emergence and spread. Strategies such as improving immunization coverage, using genetically stable vaccines, and establishing surveillance systems are critical to achieving global eradication of poliovirus and efficient monitoring of VDPVs outbreaks.

The Scourge of Poliomyelitis in Pakistan: Barrier towards its eradication.

Poliomyelitis is an extremely disabling disease caused bythe polio virus, a virus belonging to Picornaviridae family.Humans are the only natural host. The virus principallyinvolves the motor neurons resulting in permanentasymmetrical lifelong paralysis. Effective vaccines areavailable for its eradication. Unfortunately despite vaccineavailability the disease cannot be eradicated from earth yet.Pakistan and Afghanistan are the only two nationsharbouring the polio virus. Lately sporadic cases ofPoliomyelitis have also been reported from countries likeMozambique, which had an outbreak following importingof wild poliovirus (WPV1) from Pakistan.1 As long as a singlechild remains infected, children in all countries are at riskof contracting polio.2 Expanded Programme for Immunization (EPI) was initiatedin Pakistan in 1978. Polio vaccine was included along withfive other vaccines against life threatening diseases likeTuberculosis, Diphtheria, Pertussis, Tetanus, and Measles.The journey that took off smoothly with over 50% vaccinecoverage by 1990 raised to 80% coverage by 2007, hastaken a sharp dip in the ensuing decades. Pakistanunfortunately never recovered from the scourge of poliodisease. In 1988 Global Polio Eradication Initiative (GPEI)was started, that resulted in a decline to 99% cases of polioin the world, but Pakistan continued to face challengeswhich has prevented total eradication of polio.3 Continued...

Safety and Immunogenicity of Trivalent Oral Polio Vaccine in Vaccinated Children and Vaccine-Naïve Infants: A Phase 4 Study.

In the context of polio eradication, novel oral polio vaccines for type 2 (nOPV2) were developed, and types 1 and 3 polioviruses are being developed. We aimed to generate trivalent oral poliovirus vaccine (tOPV) safety and immunogenicity data as a reference for comparing with novel OPV formulations. This was a single-center, open-label, phase 4 study in March 2016 in the Dominican Republic with healthy children previously vaccinated with ≥3 doses of tOPV receiving one dose of tOPV and vaccine-naïve infants receiving 3 doses of tOPV. Safety and immunogenicity were assessed. No serious adverse reactions or important medical reactions were reported. Seroconversion (SC) rates at Day 28 in children were 32.7%, 36.7%, and 46.9% for types 1, 2, and 3, respectively, and seroprotection (SP) rates 28 days after one dose increased from 89.8% at baseline to 93.9%, 98.0% to 100%, and 83.7% to 98.0% for types 1, 2, and 3, respectively. In infants, SC rates were 88.5%, 98.1%, and 96.2% for types 1, 2, and 3, respectively. SP rates at Day 84 were 93.3%, 100%, and 96.2% for types 1, 2, and 3, respectively. This information can be used as a reference to compare with novel monovalent or trivalent OPVs under development.

Discovering vaccines: the trial tale.

This paper reviews the importance of vaccine trials to public health. Vaccines are developed to build immunity to disease, which have helped to completely eliminate smallpox, and reduced incidence of polio and measles. A variety of breakthroughs made many years ago, such as the smallpox vaccine by Edward Jenner and the discoveries by Louis Pasteur, also set the stage for modern international immunization programs. A few events, such as the licensing of the polio vaccine and the passage of the Vaccination Assistance Act helped to improve the study of vaccines. In particular, vaccine trials may be RCTs, cluster trials, or cohort studies. The sample sizes will depend on the objectives, which would include the primary and secondary endpoints. The population under study and the geographical location also affect the trial design. Preclinical evaluation is usually the starting point of vaccine trials, where the safety and efficacy are researched on animal models or cell cultures. Animal models are selected based on their similarity to the target disease. Safety is checked in Phase I, efficacy in Phase II, and both in Phase III. Phase IV is a post-marketing surveillance of the vaccine's safety in real life. Regulatory bodies play a very vital role in ensuring that vaccines adhere to a very high standard of safety and efficacy, such as the FDA, as required. Ethical considerations, such as informed consent and the rights of participants, are innate and are implemented and enforced through laws, regulations, and ethical committees. Vaccine studies vary from the drug studies as it is focused on preventing illness in healthy patients as opposed to cure of diseases in drug trials. The dramatic development in vaccine research was driven by recent pandemics, with parallel processing and data collection in real time. Clinical trials of the vaccine are a foundation stone of public health in the reduction of sickness, offering immunity to diseases, and continuing the fight against infectious diseases. The present review is aimed at describing vaccine trials and their important aspects.

Re-evaluating polio vaccination strategies in Nepal: transitioning from OPV to fIPV for sustained immunity

Re-evaluating polio vaccination strategies in Nepal: transitioning from OPV to fIPV for sustained immunity

Assessing the mucosal intestinal and systemic humoral immunity of sequential schedules of inactivated poliovirus vaccine and bivalent oral poliovirus vaccine for essential immunization in Bangladesh: An open-label, randomized controlled trial

In 2012, the Strategic Advisory Group of Experts on Immunization (SAGE) recommended introduction of at least one inactivated poliovirus vaccine (IPV) dose in essential immunization programs. We evaluated systemic humoral and intestinal mucosal immunity of a sequential IPV-bivalent oral poliovirus vaccine (bOPV) schedule compared with a co-administration IPV + bOPV schedule in an open-label, randomized, controlled, non-inferiority, inequality trial in Dhaka, Bangladesh. Healthy infants aged 6 weeks were randomized to either: (A) IPV and bOPV at 6 and bOPV at 10 and 14 weeks (IPV + bOPV-bOPV-bOPV); or (B) IPV at 6 and bOPV at 10 and 14 weeks (IPV-bOPV-bOPV). Of 456 participants enrolled and randomly assigned during May–August 2015, 428 (94%) were included in the modified intention-to-treat analysis (arm A: 211, arm B: 217). Humoral immune responses did not differ at 18 weeks between study arms: type 1 (98% versus 96%; p = 0.42), type 2 (37% versus 39%; p = 0.77), and type 3 (97% versus 93%; p = 0.07). Virus shedding one week after the bOPV challenge dose in arm B was non-inferior to arm A (type 1 difference = −3% [90% confidence interval: −6 − 0.4%]; type 3 difference: −3% [−6 to −0.2%]). Twenty-six adverse events including seven serious adverse events were reported among 25 participants including one death; none were attributed to study vaccines.An IPV-bOPV-bOPV sequential schedule induced comparable systemic humoral immunity to all poliovirus types and types 1 and 3 intestinal mucosal immunity as an IPV + bOPV-bOPV-bOPV co-administration schedule.

Health and Economic Benefits of Routine Childhood Immunizations in the Era of the Vaccines for Children Program - United States, 1994-2023.

Since 1994, the U.S. Vaccines for Children (VFC) program has covered the cost of vaccines for children whose families might not otherwise be able to afford vaccines. This report assessed and quantified the health benefits and economic impact of routine U.S. childhood immunizations among both VFC-eligible and non-VFC-eligible children born during 1994-2023. Diphtheria and tetanus toxoids and acellular pertussis vaccine; Haemophilus influenzae type b conjugate vaccine; oral and inactivated poliovirus vaccines; measles, mumps, and rubella vaccine; hepatitis B vaccine; varicella vaccine; pneumococcal conjugate vaccine; hepatitis A vaccine; and rotavirus vaccine were included. Averted illnesses and deaths and associated costs over the lifetimes of 30 annual cohorts of children born during 1994-2023 were estimated using established economic models. Net savings were calculated from the payer and societal perspectives. Among approximately 117 million children born during 1994-2023, routine childhood vaccinations will have prevented approximately 508 million lifetime cases of illness, 32 million hospitalizations, and 1,129,000 deaths, at a net savings of $540 billion in direct costs and $2.7 trillion in societal costs. From both payer and societal perspectives, routine childhood vaccinations among children born during 1994-2023 resulted in substantial cost savings. Childhood immunizations continue to provide substantial health and economic benefits, while promoting health equity.

Flowing Prosperity: Empowering Riverbank Communities in Rajshahi City

This study investigates strategies to enhance the quality of life for riverbank communities in Rajshahi City, Bangladesh, situated along the Padma River. A comprehensive analysis of socioeconomic, environmental governance, and community aspects, the study identifies key challenges and opportunities. By paying attention to the natural resources and cultural heritage of the riverbanks, the endeavor seeks to foster socio-economic growth, environmental sustainability, and cultural preservation. Findings reveal pervasive socio-economic disparities, exacerbated by environmental degradation and governance shortcomings. The study also indicates that only 78% of inhabitants take the polio vaccine and the Body Mass Index shows 72% of people are under-weight. Despite these challenges, the study highlights community resilience, and the potential of grassroots initiatives to effect positive change. The study emphasizes the importance of integrated and participatory approaches to address the multifaceted issues facing riverbank communities. By prioritizing socio-economic equity, environmental sustainability, and community empowerment, it is possible to create inclusive and resilient communities along the riverbanks of Rajshahi City in Bangladesh. Through collaborative efforts including local stakeholders, governmental bodies, and non-profit organizations, the study creates opportunities for inclusive participation, enhances livelihoods, and promotes resilience against socio-economic challenges. The authors identify why these (River-bank people) cannot manage the sustainability of river ecosystems, health problems, and sustainable development, which advocates for a harmonious balance between social, economic, and environmental dimensions. Finally, a well-thought-out recommendation has been drafted by the authors.

Safety and 6-month immune persistence of inactivated poliovirus vaccine (Sabin strains) simultaneously administrated with other vaccines for primary and booster immunization in Jiangxi Province, China

ObjectivesThis study aims to evaluate the safety of a new inactivated poliomyelitis vaccine (Sabin strains) (sIPV) for large-scale use in primary and booster immunizations, whether simultaneously administered with other vaccines or not and to explore the persistence of all vaccines at approximately six months after vaccination. MethodA total of 3200 infants were recruited into this study, including 2000 infants aged 2–3 months randomly assigned (1:1) into the “sIPV basic” or the “sIPV+DTaP” group for primary immunization of sIPV. Another 1200 children aged 18 months old and above were randomly assigned (2:2:1:1) into the “sIPV booster,” “sIPV+HepA-I,” “sIPV+MMR”, or “sIPV+HepA-L" group for booster immunization of sIPV. Adverse events within 30 days of each vaccination dose in all participants were self-reported by guardians using a WeChat mini-program. Approximately 200 blood samples were collected at 5–7 months after the final vaccination to test for antibodies against poliovirus and other viruses. Results3198 participants in total were included in the safety study, including 1999 infants aged 2–3 months old and 1199 children aged 18–26 months old.For primary immunization, the incidence of adverse reactions in the “sIPV basic” and the “sIPV+DTaP” group were 3.19 and 6.21% (P = 0.001), respectively. For booster immunization, the incidences of adverse reaction for the “sIPV booster” group were 2.25%, while the incidence for the “sIPV +others” group in total was 2.50% (P = 0.788). Most adverse reactions were mild. Fever was the most common symptom in all groups. No vaccine-related serious adverse events (SAEs) were observed in this study.The seropositivity rates of antibodies in the “sIPV basic” and the “sIPV+DTaP” group were 92.31 and 100% against type 1 poliovirus (P = 0.031); 96.15% and 98.57% against type 2 poliovirus (P = 0.575); 98.08% and 91.43% against type 3 poliovirus (P = 0.237), respectively. Regarding booster vaccination with sIPV, whether co-administered with other vaccines or not, the seropositivity rates of antibodies against the three types of polioviruses were all 100%. Seropositivity rates of antibodies against hepatitis A, measles, mumps, and rubella were all no <77%, except for pertussis, which was <30%. ConclusionsIPV demonstrated good safety and immune persistence for primary and booster vaccinations, whether administered singly or simultaneously. Antibodies against hepatitis A, measles, mumps and rubella were not disrupted by the co-vaccination. However, the seropositivity rates and geometric mean concentrations (GMCs) of antibodies against pertussis indicate the necessity for a booster dose.

Enterovirus A71 2A-S125A acts as an attenuated vaccine candidate, indicating a universal approach in developing enterovirus vaccines.

Enteroviruses are important human pathogens with diverse serotypes, posing a major challenge to develop vaccines for individual serotypes, the success of polio vaccines in controlling and eradicating polio, along with the recent emergence and high prevalence of enterovirus-caused infectious diseases, highlights the importance of enterovirus vaccine development. Given our previous report on enteroviruses weakened by the 2 A S/T125A mutation, we assessed the potential of the EV-A71 2A-125A mutant as a vaccine candidate to address this challenge. We found that the 2A-125A mutant caused transient mild symptoms, low viral loads, and no significant pathological changes mild pathological changes in hSCARB2-KI mice, producing long-lasting cross-neutralizing antibodies against two EV-A71 wild strains. Pre-exposure to the 2A-125A mutant substantially protected against the EV-A71 Isehara wild-type strain, causing minor pathologies, significantly reducing muscle and lung inflammation, and preventing neurological damage, with reduced viral loads in vivo. Pre-exposure also distinctly suppressed the expression of pro-inflammatory cytokines, correlating to the severity of clinical symptoms. Collectively, the EV-A71 2A-125A mutant was attenuated and could generate a robust and protective immune response, suggesting its potential as a vaccine candidate and global solution for specific enterovirus vaccine development.

Progresses Toward Polio Eradication in Asian Countries: Its History and Japan's Contributions.

Japan experienced a large outbreak of wild poliovirus in the 1960s. The government made an exceptional decision to import oral polio vaccines (OPVs) from the Soviet Union and Canada while bypassing the usual approval process for medical products. Mass vaccination and subsequent, routine immunization successfully contained the wild poliovirus; the last case in Japan was reported in 1980. Domestic OPV had been used to sustain Japan's polio-free state. In 2012, the world's first inactivated polio vaccine developed from the Sabin vaccine replaced OPVs. Domestic vaccines combined with Sabin-derived inactivated polio vaccine are currently used in Japan. When the World Health Assembly announced the Global Polio Eradication Initiative in 1988, the Japanese government made a commitment to support endemic countries. The Japan International Cooperation Agency supported the establishment of microbiological laboratories, surveillance, distribution of polio vaccines and capacity building. Vaccine-derived poliovirus emerged as a new, international risk in the early 2000s. Vaccine-derived poliovirus was also detected in several Asian countries and required an outbreak response with additional vaccinations and strengthened surveillance. Genetically stable, novel, oral polio vaccine type 2 became available for use in outbreak responses and was used in Indonesia. Japan maintains its commitment to work toward the eradication of the poliovirus.

PEMBERIAN EDUKASI TENTANG PENTINGNYA IMUNISASI LENGKAP DAN VAKSINASI POLIO

Immunization is a public health intervention that is very effective in preventing serious infectious diseases. In this context, polio vaccination plays an important role because polio can cause permanent paralysis and even death. The aim of this activity is to increase knowledge, awareness and community participation about the importance of immunization, especially polio vaccination, through providing accurate information and eliminating misinformation, as well as facilitating access to health services. Method: This service begins with preparation and includes monitoring and evaluation. Where the interventions carried out are counseling, distribution of educational materials, door-to-door visits, and mobile posyandu to the community. Results: there has been a significant increase in knowledge, awareness and positive attitudes of the community towards immunization and polio vaccination. The evaluation showed a 45% increase in knowledge and a supportive change in attitudes. Conclusion: Service activities in Bandar Kidul Village succeeded in increasing the community's knowledge and positive attitudes towards polio immunization. This activity could be a model for other regions and is recommended to be held regularly with structured material and developed for maternal and child health (KIA).

Immunodeficiency-Related Vaccine-Derived Poliovirus (iVDPV) Excretion in an Infant with Severe Combined Immune Deficiency with Spillover to a Parent.

In order to maintain the polio eradication status, it has become evident that the surveillance of cases with acute flaccid paralysis and of environmental samples must be urgently supplemented with the surveillance of poliovirus excretions among individuals with inborn errors of immunity (IEI). All children with IEI were screened for the excretion of poliovirus during a collaborative study conducted by the ICMR-National Institute of Virology, Mumbai Unit, ICMR-National Institute of Immunohaematology, and World Health Organization, India. A seven-month -old male baby who presented with persistent pneumonia and lymphopenia was found to have severe combined immune deficiency (SCID) due to a missense variant in the RAG1 gene. He had received OPV at birth and at 20 weeks. Four stool samples collected at 4 weekly intervals yielded iVDPV type 1. The child's father, an asymptomatic 32-year-old male, was also found to be excreting iVDPV. A haploidentical hematopoietic stem cell transplant was performed, but the child succumbed due to severe myocarditis and pneumonia three weeks later. We report a rare case of transmission of iVDPV from an individual with IEI to a healthy household contact, demonstrating the threat of the spread of iVDPV from persons with IEI and the necessity to develop effective antivirals.

Factors Influencing Community Engagement during Guinea Worm and Polio Eradication Endgames in Chad: Recommendations for "Last Mile" Programming.

Community engagement is a strategy commonly used in health and development programming. Many disease eradication programs engage with communities through different structures and mechanisms to detect, report, contain, and respond to the diseases they target. Qualitative operational research was conducted in a district of Chad co-endemic for both dracunculiasis (i.e., Guinea worm disease) and circulating vaccine-derived poliovirus to reveal factors influencing community engagement behavior in the context of eradication-related programming. Women and men from six communities and stakeholders from the local, district, and central levels were recruited to participate in focus group discussions and semi-structured in-depth interviews. A thematic analysis was performed to identify barriers and facilitators of community engagement. Barriers to community engagement included mistrust in exogenously established health program initiatives (i.e., initiatives designed by partners external to targeted program communities) resulting from negative past experiences with external entities and community groups and the lure of profit-motivating community engagement. Subgroup and intersectionality analyses revealed that gender and other identities influence whether and to what extent certain members of the community engage in a meaningful way. Facilitators of community engagement included leadership and the influence of authorities and leaders in community participation, perceived benefits of being engaged with community-based initiatives, and use of incentives to enhance community participation. Study findings may be used to inform the refinement of community engagement approaches in Chad and learning agendas for other "last mile" disease eradication programs.

Molecular epidemiology of enteroviruses from Guatemalan wastewater isolated from human lung fibroblasts.

The Global Specialized Polio Laboratory at CDC supports the Global Poliovirus Laboratory Network with environmental surveillance (ES) to detect the presence of vaccine strain polioviruses, vaccine-derived polioviruses, and wild polioviruses in high-risk countries. Environmental sampling provides valuable supplementary information, particularly in areas with gaps in surveillance of acute flaccid paralysis (AFP) mainly in children less than 15 years. In collaboration with Guatemala's National Health Laboratory (Laboratorio Nacional de Salud Guatemala), monthly sewage collections allowed screening enterovirus (EV) presence without incurring additional costs for sample collection, transport, or concentration. Murine recombinant fibroblast L-cells (L20B) and human rhabdomyosarcoma (RD) cells are used for the isolation of polioviruses following a standard detection algorithm. Though non-polio-Enteroviruses (NPEV) can be isolated, the algorithm is optimized for the detection of polioviruses. To explore if other EV's are present in sewage not found through standard methods, five additional cell lines were piloted in a small-scale experiment, and next-generation sequencing (NGS) was used for the identification of any EV types. Human lung fibroblast cells (HLF) were selected based on their ability to isolate EV-A genus. Sewage concentrates collected between 2020-2021 were isolated in HLF cells and any cytopathic effect positive isolates used for NGS. A large variety of EVs, including echoviruses 1, 3, 6, 7, 11, 13, 18, 19, 25, 29; coxsackievirus A13, B2, and B5, EV-C99, EVB, and polioviruses (Sabin 1 and 3) were identified through genomic typing in NGS. When the EV genotypes were compared by phylogenetic analysis, it showed many EV's were genomically like viruses previously isolated from ES collected in Haiti. Enterovirus occurrence did not follow a seasonality, but more diverse EV types were found in ES collection sites with lower populations. Using the additional cell line in the existing poliovirus ES algorithm may add value by providing data about EV circulation, without additional sample collection or processing. Next-generation sequencing closed gaps in knowledge providing molecular epidemiological information on multiple EV types and full genome sequences of EVs present in wastewater in Guatemala.

Factors Associated with the Giving of Basic Inactivated Poliovirus Vaccine (IPV) Immunisation

Inactivated Poliovirus Vaccine (IPV) immunisation is given starting from 2-3 months of age with three consecutive doses with an interval of 6-8 weeks. IPV immunisation is one of the key steps in polio control efforts. However, there are still challenges in achieving optimal immunisation coverage in some areas. The aim was to determine the factors associated with the provision of IPV basic immunisation. This type of research uses descriptive analytics with a Cross Sectional approach where data on both variables are collected at the same time or at one time. Sampling using simple random sampling using the formula as many as 164 samples. The instruments used in the study were questionnaires and KMS Statistical tests used were chi-square. Results: The results of this study report that there is a significant relationship between knowledge (p value 0.000), work (p value 0.000), posyandu cadres (p value 0.000), posyandu officers (p value 0.000), and family support (p value 0.000) with the provision of IPV Basic Immunisation in the Working Area of Puskesmas Pulau Panggung. There is an influence of knowledge, occupation, posyandu cadres, posyandu officers, and family support on the provision of IPV basic immunisation. This study suggests that health workers should be more active in providing information to local mothers by providing information through counselling and putting up posters, banners and distributing leaflets about the importance of IPV to children or by providing information from house to house.